Diabetes Questionnaire
1.
I am confident that I am able to check my blood sugar if necessary.
Yes
No
2.
I am confident that I am able to correct my blood sugar when my sugar level is too high.
Yes
No
3.
I am confident that I able to correct my blood sugar when my sugar level is too low.
Yes
No
4.
I am confident that I am able to choose the correct foods
Yes
No
5.
I am confident that I am able to choose different foods and stick to a healthy eating pattern.
Yes
No
6.
I am confident that I am able to keep my weight under control.
Yes
No
7.
I am confident that I am able to examine my feet for cuts.
Yes
No
8.
I am confident that I am able to take enough exercise.
Yes
No
9.
I am confident that I am able to adjust my eating plan when I am ill.
Yes
No
10.
I am confident that I am able to follow a healthy eating plan most time
Yes
No
11.
I am confident that I am able to take more exercise than the doctor advises me to.
Yes
No
12.
I am confident that when taking more exercise I am able to adjust my eating plan.
Yes
No
13.
I am confident that I am able to follow a healthy eating plan when I am away from home.
Yes
No
14.
I am confident that I am able to adjust my eating plan when I am away from home.
Yes
No
15.
I am confident that I am able to follow a healthy eating plan when I am on a holiday.
Yes
No
16.
I am confident that I am able to follow a healthy eating pattern when I am eating out or at a party.
Yes
No
17.
I am confident that I am able to visit my doctor once a year to monitor my diabetes.
Yes
No
18.
I am confident that I am able to adjust my eating plan when I am feeling stressed or anxious.
Yes
No
19.
I am confident that I am able to take my medications as prescribed.
Yes
No
20.
I am confident that I am able to adjust my medications when I am ill.
Yes
No
Current Progress,
0 of 20 answered